Cochlear implantation in patients with otosclerosis of the otic capsule

Objective To evaluate outcomes of cochlear implantation of patients with otosclerosis of the otic capsule. Study design A retrospective case series of 6 patients (7 ears). Patients 6 patients (7 ears), 5 patients with severe to profound sensorineural hearing loss; 1 patient with mild to profound sensorineural hearing loss, with radiologic evidence of otosclerosis. All patients were adult males, with or without history of stapes surgery. Intervention Cochlear implantation of 7 ears. 5 patients with severe to profound sensorineural hearing loss received the Nucleus Contour Advance peri-modiolar electrode array with binaural implantation performed in one patient. One patient with mild to profound sensorineural hearing loss received a Cochlear® Nucleus Hybrid L24 device. Methods Preoperative temporal bone CT, audiometric and speech perception testing scores were reviewed, confirming presence of otosclerosis of the cochlea as well as cochlear implant candidacy. Speech perception testing included CNC words, HINT sentences and AZ Bio scores to measure hearing outcomes post implantation. Results All recipients of the contour advance device had a significant improvement in hearing at both 3 and 6 month follow up. The hybrid device recipient experienced loss of residual hearing in the implanted ear without improvement at 3 months and mild improvement at 6 months. Conclusion Cochlear implantation has proven to be effective in the treatment of patients with sensorineural hearing loss, including those with otosclerosis of the cochlea. Hybrid candidacy in the setting of otosclerosis of the cochlea may require consideration of alternative electrode devices, most likely a peri-modiolar device.